Diagnosis for Sun-Damaged Skin

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Sunshine gives your body energy, but get too much, and you could end up with sun damage. It’s important to keep an eye on your skin and get ahead of any problems. Dermatologists, doctors who treat skin problems, can perform total body exams to tell you if spots of sun damage can lead to bigger trouble ahead.

Tell All

Only you have some of the information the doctor needs to understand your skin’s story. As with most medical exams, you should tell her about any drugs you are taking, allergies, and if anyone in your family has had skin diseases or problems. But to tell how much sun damage you might have, dermatologists might ask questions you won’t hear from other doctors, such as:

Where did you grow up?

Where else have you lived?

What type of work do you do?

What do you do for fun?

How often do you spend time outdoors?

Do you tan easily?

Do you get sunburned?

Have you ever had a sunburn, even as a child? Did you have blisters? Did you go to the doctor?

Have you ever used a tanning bed?

Do you use sunscreen? Where, and how often do you reapply?

Do you wear sunglasses?

Your answers to these questions will help her fill in the blanks.

Bare All

When you go to a dermatologist, be ready to bare it all, too. You might feel embarrassed or shy, but this kind of physical exam is the best way for a doctor to look for signs of skin problems, including those caused by the sun.

The nurse will ask you to take off your clothes and give you a gown or sheet to cover up with until the doctor comes in. If you’re a man and the doctor is a woman, or vice versa, there should also be an assistant in the room.

Now, it’s time for a total-body skin scan. Here’s how it goes:

The doctor will explain that she is going to take a close look at your skin, from top to bottom, front and back, side to side, inside and out. She is looking for spots, moles, and discolored areas. She also will run her hand over the places she checks to feel for dry, scaly, or raised areas and thin or thick skin.

The doctor will circle back with a magnifying glass for an even closer look at anything that doesn’t look normal. Some dermatologists also have special lights called dermatoscopes. She’ll measure the size of spots, count them, and make notes about their shape, color, and texture. If she doesn’t explain what the problem may be, ask about it.

You won’t skip any parts in a total-body exam. This means your scalp, behind your ears, the inside of your lips, your armpits, your genitals, between your butt cheeks, between your fingers and toes, under your nails, and the soles of your feet. Again, try to put aside modesty for the sake of your health.

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A Cut and a Shave

If your dermatologist still isn’t sure about a problem area, she’ll probably want to get a tissue sample to look at more closely. This is called a biopsy.

Depending on how big the area is and how much skin the doctor needs for a diagnosis, she might shave off a small sliver, go deeper to remove a small plug of skin (a punch biopsy), or cut out the whole thing plus a small border around it (an excisional biopsy). You’ll get a shot to numb the area beforehand, and you may get a few stitches if it leaves an open wound.

Next, your skin sample goes to a lab for testing. Doctors called pathologists cut it into very thin slices and look at them under the microscope. They can tell if cells and tissue are normal or not, including if they might show signs of cancer. It usually takes 1-2 weeks to know the results of these tests.

Just because your doctor wants to do a biopsy does not mean you have cancer. It’s just one tool doctors have to make the most accurate diagnosis if something doesn’t look right. Biopsies aim to rule out problems, not just to find them.